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Organization

HOUSE OF MERCY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REBECCA PETERSON MS, CADC, LMHC (DIRECTOR)
(515) 643-6500
Entity
Organization

Contact information

Practice address
1409 CLARK ST, DES MOINES, IA 50314-1964
(515) 643-6500
Mailing address
1409 CLARK ST, DES MOINES, IA 50314-1964
(515) 643-6500

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
3245S0500X
Children's Substance Abuse Rehabilitation Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0705979
IA
Enumeration date
01/03/2007
Last updated
07/30/2018
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